Provider Demographics
NPI:1760453807
Name:LEE, CHUN WOO (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:CHUN
Middle Name:WOO
Last Name:LEE
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 JEFFERSON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2251
Mailing Address - Country:US
Mailing Address - Phone:661-721-1234
Mailing Address - Fax:661-721-1221
Practice Address - Street 1:1224 JEFFERSON ST STE 3
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2251
Practice Address - Country:US
Practice Address - Phone:661-721-1234
Practice Address - Fax:661-721-1221
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23042111N00000X
CAAC9240171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist